The pioneer home system is older than the state of Alaska. The first home, in Sitka, was repurposed from abandoned marine barracks in 1913. The state-funded system now operates in six locations and provides care to 440 of Alaska’s senior citizens. And demand is only growing.
But as lawmakers grapple with the budget, some wonder whether the state can keep funding the homes at all.
If you’re walking around Sitka, you can’t miss the pioneer home. It sits on a hill, crowned in crocuses and rose hips. And gazing out towards Sitka Sound, with a walking stick in one hand and a pickax in the other, is an enormous sculpture of a gold prospector. Around town, he’s known as “The Pioneer.”
“Almost all of the men who have come to the Alaska Pioneers’ Home are of the highest type of American trailblazer.” Those are the words of Arthur G. Shoup, the first superintendent of the Sitka Pioneer Home, read by Philip Welsh, the current administrator.
The homes were built to care for Alaska’s early homesteaders: miners, bush pilots, fisher man. Now, there are six homes and they care for Alaska’s elderly: those over 65 who have gotten off the wait list and earned a coveted spot.
As Welsh makes the rounds, he stops here and there to fix someone’s collar.
“If you end up with somebody and you see them with their shirt undone because they can’t see, button up their shirt,” Welsh said. “Allow them to be as independent as possible for as long as possible. That will help maintain their dignity.”
While few in the state would contest the importance of the pioneer homes, lawmakers are beginning to wonder whether it’s possible for the state to keep funding operations. Both the governor and the legislature want to cut at least one million dollars in state support for the pioneer homes (which is now at $37 million) and to explore privatizing some or all of the home’s services. The Walker administration is on board.
“Can somebody do the same service at the same quality for less money?” asked Pat Pitney, the budget director. “You know, most other places don’t have the state running the care homes.
Only Wyoming and Arizona have anything similar to Alaska’s “pioneer homes.” The state issued a request for letters of interest for private operators in mid-January. Four companies responded.
“For the request for letters of interest, the responses were really a no-cost way of testing the waters in terms of privatization,” said Jessica Bogard, administrative operations manager with the homes.
Among the responders was Southeast Alaska Regional Health Consortium, which offered to buy the whole system. Marathon Development Inc. from Washington and Retirement Housing Foundation in California proposed managing operations. And Juneau-based NANA Management Services, which already provides food services for all the homes, offered to tack on housekeeping and maintenance if a partner came along to manage the direct care.
The Department of Health and Social Services is now conducting a feasibility study to explore the idea. And on the revenue side, a legislative subcommittee proposed charging seniors $100 a year to keep their spot on the waitlists. 5,325 Alaskans are waiting to join the Pioneer Homes. This worries Bogard.
“We serve kind of a low-income, high-risk population, so $100 to maintain a waiting list status, I…yeah.,” Bogard said.
“These are people that don’t really have money,” said Anchorage Representative Les Gara. “We’re just depleting what’s left of their savings.”
Gara said that turning over the keys to a private operator would cripple the quality of care.
Privatization in the long run always costs more in the long run because you have to pay for profit. And when you pay for profit, the profit motive leads to lower levels of services to increase the profit. That’s what happened with private prisons. They were a failure.
Residents are already feeling the growing cost of the Pioneer Homes in their own pocketbooks. Rates jumped last year by 8.5 percent to keep up with a federal formula. So, a privately paying resident with Alzheimer’s now shells out $80,000 a year. This is a far cry, though, from private nursing homes in Alaska, where the median cost is $270,000 year. Back at the Sitka Pioneer Home, Welsh says his residents are well aware of the privatization conversation brewing at the Capitol.
“Residents…they, they’re going nuts,” said Welsh. “They’re so angry.”
So for now, Welsh focuses on the work.
“I’ve gone into rooms many times and seen a CNA sitting there with someone on their last dag, singing them a song or reading a book or holding their hand. Just not leaving them alone,” Welsh said. “Our mission statement is: we provide elder Alaskans a home and community, celebrating life through its final breath.”
And that means ensuring all residents, no matter their status and the fate of the homes entirely, will receive care until the very end.